Individual
MR. ALAN WAYNE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 S LAKESHORE DR, LAKE CITY, MN 55041-1641
(651) 345-2318
(651) 345-3310
Mailing address
108 S LAKESHORE DR, LAKE CITY, MN 55041-1641
(651) 345-2318
(651) 345-3310
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
7548443
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137R7PA
BLUE CROSS & BLUE SHIELD
MN
01
—
181341
UCARE OF MN
MN
01
—
600708
MAYO MANAGMENT SERVICES
MN
01
—
6513452318
UNITED HEALTH CARE INS
GA
01
—
6513452318
HUMANA GOLD
KY
01
—
6513452318
WAUSAU INSURANCE COMPANY
WI
01
—
7121523
PREFERRED ONE
MN
01
—
7683462
AETNA
TX
01
—
78628
HEALTH PARTNERS
MN
01
—
82-8229
MEDICA CHOICE
TX
01
—
HEALTH PARTNERS
INSURANCE COMPANY
MN
05
—
MN MEDICAID
—
MN
Enumeration date
08/03/2006
Last updated
07/09/2007
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